Provider Demographics
NPI:1659113488
Name:SERENITY REHABILIATION AND TRANSITIONAL SERVICES LLC
Entity type:Organization
Organization Name:SERENITY REHABILIATION AND TRANSITIONAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:ADT
Authorized Official - Phone:443-523-9136
Mailing Address - Street 1:2910 STAFFORD ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21223-2731
Mailing Address - Country:US
Mailing Address - Phone:443-523-9136
Mailing Address - Fax:
Practice Address - Street 1:2910 STAFFORD ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-2731
Practice Address - Country:US
Practice Address - Phone:443-523-9136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty